What "Tort Reform"? Texas Doctors Not Coming Back

Back in August we did two “Medical-Malpractice: I Told You So” posts in a row (here, here).  I really didn’t want to do another one, at least not so soon. Really. Curses, foiled again!

This is important, though, because if Congress changes hands on November 2 we’re going to be fighting med mal myths, once again.  One of the most common, which we have covered many times (here, here), is that doctors just flooded into Texas (and its underserved rural areas) after – and due to – enactment of a draconian “cap” on compensation for injured patients.  Both the Texas Observer and the Fort Worth Star-Telegram have been on top of the “debunking,” and yesterday, the Fort Worth Star-Telegram carried a new headline that said it all: “JPS official warns Texas legislators of doctor shortage.” 

Yes, that’s right.  A doctors’ shortage looms in Texas, and this comes after injured Texans relinquished their legal rights because the insurance and medical lobbies told them this was the only way to prevent a doctor shortage in Texas.  The Star-Telegram reports:

With a ratio of 158 doctors per 100,000 residents, Texas ranks 42nd among the 50 states and District of Columbia, according to the Texas Medical Association. The shortage is expected to worsen as the state's population grows and the healthcare overhaul is enacted.

"We are at a shortage of physicians of all types in Texas, both primary care and specialty care," [Dr. Gary Floyd, JPS Health Network chief medical officer] said. "We would love to see this addressed in our new healthcare reform.  How do we train more physicians?"

There is a reason for this, of course: “[C]aps and cuts in Medicare and Medicaid funding, which help pay for residencies. Those have forced many healthcare agencies to freeze or scale back residency programs.”

In other words, what’s the solution to doctors’ shortages?  Increased Medicare and Medicaid funding, incentives to encourage doctors to practice in rural areas - pretty much anything except “tort reform.”  (See more detail here.)

In other words, to quote Edvard Munch, "Aarrgghh!!"

Comments

[Long Tall Texan]

Thanks for pointing this out. It will be interesting to hear what excuse thw Mythmakers who created the so-called "Tort Reforms" will come up with for their next excuse--too many accountants?

[Texmed]

Figures don't lie, but liars can sure have their fun with figures. Any time you see something that says "always" or "never," it's time to look closer.

Of course Texas is suffering from a physician shortage. It is caused by many things, most significantly our booming population. No, our 2003 liability reforms didn't solve that problem. No one ever said that tort reform was the "only" solution. But it is definitely a significant one. Think how much worse off we would be.

Here are some facts (source: http://www.tmb.state.tx.us)

The Texas Medical Board (TMB) finished the fiscal year having received a record 4,128 new physician applications. Last year’s total of 4,094 was the previous record. This marks the fifth successive year that new physician applications have exceeded 4,000 and continues to dwarf the prereform numbers (pre-2003). TMB licensed 3,523 new doctors this year; that’s 12 percent more than last year and just 98 short of the state’s all-time record of 3,621.

[Alex Winslow]

Where are those doctors practicing, Texmed? What populations are they serving?

The facts are plain and simple. Despite the increases in applications to the Texas Medical Board, rural and under-served areas of Texas continue to fall behind. Doctors are choosing not to serve these populations for a variety of reasons that have nothing to do with medical liability. Inadequate reimbursement rates for indigent care, access to facilities, where they are trained, and crushing medical school debt all come to mind as factors that are more likely to effect where a doctor chooses to practice.

We need to be honest about this issue. So-called tort "reform" was never about improving patient access, lowering costs, or making patients safer. It was about protecting insurance companies.

If you are serious about improving health care in Texas, quit pretending that limiting patient rights has anything to do with it. Instead, let's address the core problems of costs, access, and quality with real solutions that will make the health care system better for patients and doctors.

A better way to protect patients would be to crack down on the few bad doctors that commit most of the malpractice. Let's root them out and kick them to the curb. Instead, we have a white-coat curtain that arbitrarily shields all doctors - good and bad - from responsibility.

Here's some information on what the Texas health care system looks like: http://www.texaswatch.org/wordpress/wp-content/uploads/2010/09/MedMal-Fact-Sheet-2010.pdf